InDEPENDEnt

Impact of Dietary Protein on Disability in ageing Europeans

What is InDEPENDEnt about?

The European population is ageing but, for many countries and Portugal in particular, the extra years of life are not free of disability. Diet is known to be important for health and dietary protein specifically for maintaining physical function. However, few European countries have good data on the impact of protein malnutrition on disability in later life. The Impact of Dietary Protein on Disability in ageing Europeans (InDEPENDEnt) project will contribute to the World Health Organisation’s goal of maintaining the functional capacity of older people by conducting the first data pooling of European and North American data to determine the optimal level of dietary protein (and its synergy with physical activity) to slow disability progression and provide the first reliable estimates of how many cases of disability could be prevented by an adequate protein intake in Portugal.

Objectives

  1. Provide a robust estimate of the association between low protein intake and disability progression in older European adults

  2. Investigate the synergistic effect of physical activity

  3. Estimate the number of cases of disability incidence that could be prevented in Portugal if not for protein malnutrition.

Data used

Individual level data will be harmonised and pooled from four cohorts:

  • Health, Aging and Body Composition Study (Health ABC), USA

  • Longitudinal Aging Study Amsterdam (LASA), the Netherlands

  • Newcastle 85+ Study, United Kingdom

  • Quebec Longitudinal Study on Nutrition and Aging (NuAge), Canada

Epidemiology of Chronic Diseases Cohort (EpiDoC), Portugal will be used to determine the population attributable fraction of disability due to protein malnutrition in Portugal

Results

  • Analysis of the Newcastle 85+ Study found that very old adults with higher protein intake (higher or equal than 0.8 or 1.0 grams per kilogram of bodyweight (BW) per day) were less likely to become frail if they were pre-frail to begin with and that energy intake seems to play an important role in this relationship between protein and frailty.

  • In community‐dwelling older adults, the prevalence of protein intake below the current recommendation of 0.8 g/kg aBW/d is substantial (14–30%) and increases to 65–76% according to a cut‐off value of 1.2 g/kg aBW/d.

  • In community-dwelling older adults, higher protein intake can reduce physical function decline not only in older adults with protein intake below the current recommended dietary allowance of 0.8 g/kg BW/d, but also in those with a protein intake that is already considered sufficient (i.e. above 0.8 g/kg BW/d).

  • More results will be added in the future.

Publications

  • Mendonça N et al. Protein intake and transitions between frailty states and to death in very old adults: the Newcastle 85+ study, Age and Ageing, Volume 49, Issue 1, January 2020, Pages 32–38, https://doi.org/10.1093/ageing/afz142.

  • Hengeveld L et al. Prevalence of protein intake below recommended in older adults: a meta-analysis across cohorts from the PROMISS consortium. J Cachexia, Sarcopenia and Muscle. https://doi:10.1002/jcsm.12580.

  • Mendonça N et al. Low protein intake, physical activity, and physical function in European and North American community-dwelling older adults: a pooled analysis of four longitudinal aging cohorts. The American Journal of Clinical Nutrition. https://doi.org/10.1093/ajcn/nqab051.

Dissemination

Oral communications:

  • Mendonça N et al. (2019) Protein intake and disability in the oldest old: road to “InDEPENDEnt”. Casual Friday, CEDOC, NMS, UNL, Lisbon, Portugal, 4th October;

  • Mendonça N et al. (2019) Protein intake and frailty in very old adults: the Newcastle 85+ Study. In the 13th European Nutrition Conference, Dublin, Ireland, 15-18th October;

  • Mendonça N et al. (2019) Protein intake, sarcopenia, frailty and disability in very old adults: findings from the Newcastle 85+ Study. In the 15th International Congress of the EuGMS, Krakow, Poland, 25-27th September;

  • Mendonça N et al. (2020) Protein intake and disability in the oldest old: road to “InDEPENDEnt” and descriptive results. Postdoc Exchange Program, IGC, Lisbon, Portugal, 26th February;

  • Mendonça N et al. (2020) Protein intake, physical activity and physical function in older adults: a pooled analysis of four longitudinal studies on ageing. ESPEN Virtual Congress on Clinical Nutrition & Metabolism, 19-21st September;

  • Mendonça N et al. (2020) Protein intake, physical activity and physical function in older adults: a pooled analysis of four longitudinal studies on ageing. EuGMS E-Congress, 7-9th October.

  • Mendonça N et al. (2021) Low protein intake, physical activity and physical function in older adults. Universidade Federal de Alfenas - Minas Gerais, 15th April.